May 12, 2026 • 23 mins
This week, we’re getting real about hormones with Cally Smith from Advanced Medical Wellness because apparently being exhausted, overstimulated, anxious, bloated, emotional, unable to sleep, and forgetting why you walked into a room isn’t just “being a busy woman.” Cute! We answered listener questions and talked all things hormones, including:
- low energy & burnout
- weight changes & belly fat
- mood swings & anxiety
- sleep issues
- perimenopause
- libido changes
- peptides, wellness, and feeling like yourself again
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
What's up, guys. I'm so excited.
Speaker 2 (00:03):
I've been talking about my hormone journey for what six
months now and how I've been going to Advance Medical Wellness,
and I'm so pumped because Callie is joining us. She's
the owner and practitioner at Advanced Medical Wellness.
Speaker 1 (00:17):
Welcome, thank you. It's a pleasure to have you after
all this time.
Speaker 3 (00:21):
So excited to be here.
Speaker 2 (00:22):
I know. So I've been sharing my journey on social
media for the last I think since September of last year,
and I was like, you know, I want to go
through this journey and really have some like experience under
my belt before I start talking about it, right because
I'm like, I want to make sure that I'm recommending
something that I really believe in, and naturally I do.
Speaker 1 (00:43):
And so I was like, we.
Speaker 2 (00:44):
Got to get Cally in here to tell people we
have lots of questions. So we had a lot of
listeners comment yesterday and want to ask you questions. So
should we just like dive right in? Dive in, Okay,
before we get to the question, So I do want
you to tell me a little bit about Advanced Medical
Wellness and why you started the practice.
Speaker 3 (01:01):
Yeah, absolutely, So I started Advanced Medical Wellness in August,
still be four years ago, and I really started the
practice out of a passion for the industry. I want
people to feel better, whether that's losing weight, whether that's
fixing their hormones, whether it's just being a good practitioner
where people can walk in and know that you know,
(01:22):
no matter what's wrong with them, they feel sick or
they feel tired, we're there for them and we can
help them. So it's really just a passion for the
industry and just wanting people to live healthier and live longer.
Speaker 2 (01:32):
Love that, And you guys are in all women's staff,
which is pretty cool.
Speaker 1 (01:35):
Yeah, yeah, I love that.
Speaker 3 (01:36):
Yeah yeah, as a girl, absolutely.
Speaker 1 (01:39):
One of my favorite parts.
Speaker 2 (01:40):
Yeah, tell us about the main three hormones in a
woman's body and how they affect their function every day.
Speaker 3 (01:47):
Yeah. Absolutely, So the three hormones that we usually focus
on are estrogen, progesterone, and testosterone. We have other hormones
in the body, but those are the three that we
can control, so those are really what we're looking for.
And so when it comes to estrogen, you think bone health,
you think heart health, you think collagen in our skin
(02:09):
and things like that. Testosterone is the one that's really
important for energy, okay, sleep, libido, things like that. And
then we've got progesterone and that's really the calming hormone.
Typically we give that at night. That's because it helps
with mood. It's really calming and it kind of stabilizes
our mood.
Speaker 1 (02:26):
Okay, And that's the trifecta.
Speaker 2 (02:28):
Those are the three that we're trying to that's get
optimal results with.
Speaker 3 (02:32):
Those are the three as a provider that I can control,
that I can help with, and that's why we focus
on those.
Speaker 2 (02:38):
So you offer something called bioidentical hormone replacement. What does
bioidentical mean?
Speaker 3 (02:44):
Yeah, absolutely, it's a great question. So bioidentical is exactly
how it sounds. It's identical to what our bodies are making.
So what they're saying is, even though we're taking it
from the outside in and our body isn't making it itself,
it's identical. They've created in the lab what's identical to
kind of what our body is used to, so we
(03:05):
use it better and it's safer. So when you hear
about hormones, it's either bioidentical or synthetic. And the one
thing that we always focus on is bioidentical because our
bodies accept it better.
Speaker 1 (03:15):
Okay, and synthetic is like, quote unquote not real. It's
like hormones.
Speaker 3 (03:19):
It's close. Here's the thing. It's close the way that
they make it in the lab, but our body doesn't
like it as much as our natural So we almost
have to trick our bodies into thinking that we're actually
making it so we can get the result that we
want when we give it to the patient.
Speaker 2 (03:33):
A lot of times women go into the doctor and
they get their blood work and they're like everything's fine,
and they're like, I don't feel like everything's fine.
Speaker 3 (03:41):
Yeah.
Speaker 2 (03:42):
So for the women out there that are going to
go get blood work, what do they need to ask
for to get a more in depth reading or look
into their hormones instead of being told everything's fine.
Speaker 3 (03:52):
And So, as my career has progressed and I've learned
a lot more and I have a lot more education,
I've learned that when you go into the doctor or practitioner, nurse, practitioners, pas,
it matters who you're sitting in front of. Okay, what
you have to understand is years ago when they decided
(04:12):
what's normal. What they really did is they took let's
say a thousand patients, and they said, and it looks
it's kind of shaped on a bell curve, right, And
they're saying, Okay, the bulk of these ninety five percent
of patients is what we're going to consider normal. But
what you don't consider is those ninety five patients that
are normal could have diabetes. Those ninety five percent of
(04:35):
patients could have hypertension, high blood pressure, they could have
high cholesterol, they could have active cancer and not know
about it. So that's what you really have to ask yourself.
It can't be if you don't If your lab says
that you're normal, but you don't feel normal, you are
not normal.
Speaker 1 (04:50):
Let's talk about testosterone specifically.
Speaker 2 (04:52):
Okay, when women hear the word testosterone, it's kind of intimidating.
Speaker 1 (04:56):
I'm not gonna lie. I was also intimidated at first. Yeah,
So are.
Speaker 2 (05:01):
There things that we as women should worry about when
we take testosterone like a deeper voice, or more body
hair or acne like those kind of things.
Speaker 3 (05:10):
No, all great questions and all great concerns, but again,
sitting across from the right provider, you should be able
to bring these things up, and the provider should be
able to give you the data and the evidence to
say there's really nothing to worry about. So I think
when you know, just to give you a reference point,
a woman's testosterone optimally, if you look at a lab,
they're going to say five to forty's normal. Well, optimal,
(05:31):
we know that we like levels around eighty to one hundred,
and anecdotally in my practice, I know that women feel
better there, and when they feel better, they function better.
So if you think about it, optimal for a man
is usually over like eight hundred and so what Yeah,
we are not trying to get a woman over eight hundred.
That is no way we tried to you.
Speaker 2 (05:50):
Okay, So when you're balancing optimally for a woman, your
levels are around one hundred, where a man's is eight hundred.
Speaker 1 (05:57):
So we're nowhere near where a man's TESTASAE.
Speaker 3 (06:00):
I mean, I have men that run eleven twelve hundred,
so my goal is always a man over eight hundred.
But that's not one hundred percent of time. If I
have a guy that's six fifty, but he feels amazing,
rock on.
Speaker 1 (06:12):
So is it true?
Speaker 2 (06:13):
Though? Then hormones aren't necessarily a specific range.
Speaker 1 (06:17):
It is more based on how you feel.
Speaker 3 (06:19):
Absolutely.
Speaker 2 (06:20):
So if I feel good at like sixty, that's great,
but someone else could feel terrible at eighty and then
need to bump it up.
Speaker 3 (06:27):
Absolutely. And the other question is a lot of times
it's not just medication. Right, you feel good at sixty,
the next person comes at a one hundred and they're like, gosh,
I'm still tired. As a provider, I'm looking and I'm saying,
how's your sleep, are you drinking enough water? Are you exercising?
What's your stress level? Like, all those external things affect
(06:47):
the way that our bodies function, and they accept medication.
So those are things that need to be addressed.
Speaker 2 (06:51):
Yeah, we can't just like take hormones and then expect
it all to be fixed. I still like lay in
bed at two am and eat a cheeseburger. I think
it's going to be fine. As a woman, When you
hear about hormone therapy our entire lives, it's like, that's menopause.
That's when you're in your forties and fifties and sixties.
But a lot has shifted recently and now women in
(07:13):
their thirties are starting to address it. What can women
in their thirties start looking for and being like.
Speaker 1 (07:19):
Okay, this isn't normal.
Speaker 2 (07:20):
This is something that needs to be addressed before it
gets too far off.
Speaker 3 (07:23):
Oh my gosh. Absolutely, so I think that what's important
when you think about hormones, the big one is energy,
brain fog, hair thinning, changes in your skin. Maybe you
start carrying weight around the mid section. Maybe you all
of a sudden have some sudden weight gain and you
didn't change anything. So those are really or mood swings.
(07:43):
Your mood could be really low, your mood could be
really high. I have patients every day come in think
that they're struggling with mental illness and Priscilla, it's a
hormone imbalance, and we fix their hormones and they're like,
oh my gosh, Kelly, I'm not anxious anymore. And I'm like,
it was just your hormones.
Speaker 2 (07:57):
It's really crazy because we are taught to be accepting
of like that's just how it is.
Speaker 1 (08:02):
When you age, you age and all of that changes.
Speaker 2 (08:05):
But I don't think people realize and if they did
that just by hormone balancing and getting your hormones in check,
you can revert back to what feels normal for you.
Speaker 3 (08:15):
Oh my gosh. Absolutely, And you know.
Speaker 1 (08:17):
The belly fat doesn't have to be there. Doesn't just
because you're older.
Speaker 3 (08:23):
No, and it doesn't. And you know what, I think
that patients get stuck in the mindset of what's happening
right here, right now means forever. Yeah, But the beauty
of life and the beauty of all of it is
that it can be changed with the right team in
front of you. Yes, anything is possible. And I know
sometimes to think about it, when your mood's low and
(08:44):
you don't feel good and you're unhappy with your weight,
you're thinking, this is me forever, this is just how
it's going to be, and it's not true. Get the
right provider and get the right team in front of you,
whether that's me or whether that's my colleagues that are
great at this. Anything's possible. It really is. As long
as you're willing to show up and walk through my doors,
it's totally possible.
Speaker 2 (09:02):
How do you know when it's time to start hormone
replacement therapy and at what age should women start paying
attention to that?
Speaker 3 (09:08):
Yeah? So what you really the best predictor for us
as providers is your mom. So if mom went into
early menopause, that's usually a good predictor for us. Not always, yeah,
not always, but sometimes when you're ovaries, which are what
produced all of these hormones that we're talking about, when
they fail early, meaning they just don't work like they should,
(09:31):
not that they fail, just that they're not producing what
they should, we call it premature ovarian failure. And typically
it's genetic. Typically we can see that in your heritage
home or whether mom didn't or grandma did. Usually we
can track that. Sometimes not everybody's body is different. We
have some women that go through chemotherapy that will cause
(09:52):
them to go into menopause early. So I don't you know, honestly,
Priscilla is a twenty one year old going to walk
into my office. Probably not. But in your thirties, if
things are changing and you don't feel normal, there's usually
a reason, you know, whether you think it's hormones and
we get your blood work and it's not, you still
(10:15):
need to talk to somebody. So I don't think there's
a right or wrong answer. But what I will say
is there's a lot of data since twenty twenty two
that's come out that's proved to us that actually replacing
estrogen in the mid to late thirties protects our bone,
it protects our the neurons in our brain, it protects
(10:35):
our heart. So there's a lot of benefit to It's.
Speaker 2 (10:38):
That's great to hear because again, like I remember, I
went to a provider in obgyn and I was like,
my cycle changed, and it wasn't like a gradual getting
older change. It was like within three months, it was
just different. And her response was, well, you're getting older, right,
And I'm like, I get that, but also it shouldn't
be that like I have been. I've had the same
(11:00):
for like ten, twelve, fifteen years, and so you're telling me.
So not getting dismissed is also a big deal, and.
Speaker 1 (11:09):
Being heard is so important.
Speaker 2 (11:11):
And I think that's what's really great about your guys
this practice is because I think I've like ran over
my appointments so many times because I've just shared so much. Yeah,
you just listen, absolutely, and that's the best part because
you consume everything that your patients say, and then you
uniquely because my husband also is a patient and our
visits are vastly different, and not just because we're men
(11:32):
and women, but because his needs are so different than mine.
And that's what's super cool is because like you accommodate
everyone individual. It's not like a one size fits all.
Speaker 3 (11:40):
No, you have to meet patients where they're at. I mean,
that's what's important. It's you know, I precept nurse practitioner
students and I always tell them, I say, you know,
I'm not the smartest nurse practitioner out there, and I
didn't graduate the top of my class. Close, not the top,
but close. But I always tell them, I say, the
(12:00):
reason I accept nurse practitioner students and I extend myself
to them is to show them that there's a different
side of medicine. And so that's the most important part
is I don't know everything, and I'm not the smartest
person in the room, but I won't give up and
we'll figure it out.
Speaker 2 (12:16):
That's I mean, I think that's all any patient can
ask for. Absolutely, who would you say hormone therapy is
safe for?
Speaker 1 (12:23):
And who do you not recommend getting it done?
Speaker 3 (12:26):
Yep? Absolutely So when you do a consult history of
cancer is very important. So it's funny because you hear
everybody's talking about hormones now prior to twenty twenty two
is taboo. That's because a study came out in twenty
twenty two. Previously, we thought if you go on bioidentical
(12:47):
estrogen and testosterone, that it was going to increase your
risk for breast cancer. And so when we hear that
as providers, our number one oath is to do no harm.
We're not even going there for sure. So in twenty
twenty two, a great study came out and basically told
us that everything we thought you wasn't true. Breast cancer
is very important to us, Ovarian cancer is very important
to us, Uterine cancer is very important to us. Those
(13:08):
patients we absolutely wouldn't we wouldn't risk now. Is that
a blanket statement of one hundred percent of patients with
a history of breast cancer any type of cancer as
a no no. But they usually have an oncologist, and
that's my job to collaborate with the oncologists to say, hey,
this is what we got. Is there any options here now?
Speaker 2 (13:26):
Is it for all of the hormones or just estrogen specifically,
So it's it's all of the hormones, because what you
have to understand is there's a balance.
Speaker 3 (13:35):
So we are, you know, our ovaries make our ovaries
and adrenal glands make the three hormones. But it's all
about the balance. So we can give one, we can
give two, we can give three, but what we really
want is that perfect synergy between all of them. So
it's not just it's not just estrogen. What we think
a lot of breast cancer now we hear feeds off estrogen, right,
(13:56):
But what you have to understand is when your testosterone
levels starts to increase, your body sometimes wants to turn
that into estrogen, and so we would be very careful
with that. If the patient has a history of any
type of breast cancer.
Speaker 2 (14:07):
And is it cancer with them specifically or their family lineage.
Speaker 3 (14:13):
It's really just the person. If there's a history a
breast cancer, there is a breast cancer gene called the BRCA.
We call it the BRAKA. You know, we would be
very very cautious if a patient that's a positive. Absolutely,
and but it's it's a it's a team effort. I
can't tell you how many conversations I've had with oncologists, Hey,
(14:34):
what do you think moving forward? And cardiologists too. You know,
if there's any subspecialty in the mix, you know, oncology,
heart usually neurology not so much. But it's important that
the practitioners willing to collaborate with that subspecialty to make
sure that it's safe for the patient.
Speaker 2 (14:49):
Can hormone therapy and glp ones help women with pcos absolutely?
Speaker 1 (14:55):
Okay, tell us all about is, what, when, where? And why?
Speaker 3 (14:58):
Isn't it beautiful? Oh my gosh? Okay, So my core.
I have a specialized certification in OBCD medicine. So that's
OBCD is defined as people think struggling with their weight,
but it's really just a woman's body fat percentage over
thirty four percent or a body mass index over thirty
or a body mass index over twenty seven with a
(15:18):
comorbid condition, meaning you have high blood pressure, high cholesterol
with that. So GLP one medications are great for weight loss, right,
they were originally designed for diabetes, now we use them
for weight loss. When women have polycystic ovarian syndrome, a
lot of times they have cysts and things like that,
and that can cause metabolic dysregulation. It can cause them
(15:40):
to their insulin levels are high, which makes them store
body fat, which is why a lot of times they'll
carry fat around the mid section. So GLP wants help
with that. The insulin levels go down, they lose weight,
and the PCOS tends to resolve itself. Wow, So not completely.
I have seen it.
Speaker 2 (15:58):
You know.
Speaker 3 (15:58):
I've had lots of patient who had had a diagnosis
of PCOS, you know, in their younger years, and they
get on GLP ones. They do great, we clean up
their diet, they lose a bunch of weight and they don't.
Speaker 1 (16:11):
Have undetectable don't have it.
Speaker 2 (16:12):
That's amazing how much distress and cortisol actually impact our
hormones and what can we realistically.
Speaker 3 (16:20):
Do about it?
Speaker 1 (16:23):
Like it's the biggest one.
Speaker 3 (16:24):
Okay, so it's totally the biggest one. Because I feel
like hot topics come out, right, hot topics come out,
women's testosterone. We're gonna talk about it. You know, Cortisol.
Cortisol does. Cortisol's a stress hormone. It makes us hold
on to body fat. It can slow metabolism. Absolutely. Here's
(16:45):
the tricky thing with cortisol. There's nothing we can do
about it. So sometimes I'll have patients come in and
they're like, oh, my cortisol's probably through the roof. Can
we check it? Yes, realistically, we can check it, but
as a provider, I feel like I need to be
honest with you. And even if we have this high result,
there's nothing we can.
Speaker 1 (17:03):
Do about it because is it lifestyle related?
Speaker 3 (17:05):
It is it stress, So you have to.
Speaker 2 (17:07):
Manage your lifestyle. There's nothing Kelly can do for you,
at least in that department.
Speaker 3 (17:12):
Yeah, and here's the thing, you know, I feel like
it's lifestyle stress, but I think more plays into that too.
What's your diet look like? Yeah? Are you struggling with
anxiety depression? Can we get you into a therapist, you know,
to make you feel a little better. Are you exercising?
Speaker 2 (17:28):
Like?
Speaker 3 (17:28):
There's other things that we can do to lower that,
do you know what I mean. It's just it's hard
for me as a provider because gosh, I wish I
had something to give people except like, oh, hey, go
get a new job, Like that's going to happen, right, Yeah,
But I feel like, yes, it does, but unfortunately there's
not a lot that we can do about it.
Speaker 1 (17:46):
Yeah, but that's good to know that.
Speaker 2 (17:49):
See. I like that honesty though, because then it gives
people the reality and it makes them look within and
it's like, Okay, this is something I need to internally fix.
I can't outsource, say, you know what I mean. There
are a bunch of different ways to take hormone therapy. Yes,
what are those ways and what does your clinic offer?
Speaker 3 (18:08):
Yes, so there are many different ways to take it.
Estrogen can be taken by a tablet. Estrogen can be
taken by cream, Estrogen can be taken by patch. Progesterone
can be taken by injection. Progesterone can be taken by
a capsule, and then testosterone. There's creams, there are trophies
(18:30):
which are just kind of like tabs that dissolve in
your cheek, under your tongue, and then there's injection. So
I will tell you as a provider, I don't have
a lot of absolutes in my life, right. I like
the gray area. I think that everybody's different and we
kind of have to bend and move to find what works. Yeah,
the one hard and fast I have in my practice
(18:51):
is I only give bioidentical hormones a certain way. So
I only give estrogen by patch because when you take
it orally you can have an increased risk for blood clots.
Sometimes women don't do very well with it. Orally. It
can be hard, a little bit harder on your liver.
And if I give a woman a cream, what if
you put on a shirt and you sweat in Arizona
(19:12):
and I don't know your rate of skin absorption versus
the person next to me. But if I give it
to you via patch, I know that you're going to
absorb that. We can do twice weekly patch, once weekly patch.
I can control the estrogen that's going in your body.
Testosterone I only give by injection. It's going right into
your bloodstream. Yeah, we can control it. Like that's my
(19:32):
big thing is new. There's pellets. Two pellets are the
big thing. They do the surgical procedure. They put these
pellets in and it's like, oh, hey, have a great time,
see you in three months. Hope you don't have a
side effect because there's nothing I can do about it.
If I give somebody testosterone and say they're an over
responderikey for the record, I can fix it in real
time in one week, Like I can fix it.
Speaker 1 (19:54):
I was I am that person.
Speaker 2 (19:56):
I So I'm doing testosterone injections and my body is
super sensitive, so we have had to adjust my dose
like five times. I think and it's all I mean,
it's me, it's my body and the way it's responding
because I've never done it before, right, So we're learning
as we go, and I am so grateful for the
weekly option versus like, can you imagine if you would
have started me and I had a pellet and I
(20:18):
would have had three months of like skyrocketed testosterone.
Speaker 3 (20:21):
Absolutely, you felt terrible.
Speaker 1 (20:22):
It would have been awful.
Speaker 3 (20:24):
So that's the one I'm so I'm such a I
call myself a control frequ when it comes to the
way that I give hormones. But they're the most data
driven I can. I can predict the outcomes so much
better than I can these ones where you take it
orally you know, you maybe absorbed thirty forty percent of it.
So that's how I give testosterone. It's just subcutaneous injection, right,
(20:46):
that doesn't have to go on the muscle, It's just
a little insulin needle. And then progesterone is micronized capsule
at night, and that's the safest way to give progesterone.
Speaker 1 (20:54):
Yeah, I love that.
Speaker 2 (20:56):
Okay, And for the record, I do progesterone and testosterone
and I've not had any issues, so far Ye, we're good.
Speaker 1 (21:03):
Last question.
Speaker 2 (21:04):
Now someone's gonna come to advance medical wellness and they
want to start from the beginning. They've never done this,
no experience. What does that look like from beginning to
start of treatment?
Speaker 3 (21:14):
Yeah? Absolutely so they would you would call, you would
book online. You would talk to our patient coordinator, which
typically is my registered nurse who's amazing, by the way,
So she'll give you a whole breakdown of the program,
kind of the ins and outs, and talk to you
is a patient too, what are you feeling? Because she
can get a good gauge as to kind of what's
going on with a patient before they get to me.
(21:34):
So you'll get booked with me. We'll get blood work
at your first visit. We typically like it to be fasting.
We're gonna check, We're gonna I'm gonna go in depth, right,
I'm gonna check your blood sugar levels. I'm gonna check
your cholesterol. I'm gonna check your vitamin D levels because
those numbers matter too. I can't tell you how many
times I've had a patient sitting in front of me
thinking it was hormones and part it was, but they
(21:56):
were a diabetic and they never knew it. Oh wow,
absolutely so, So it's one of those things or really
low vitamin D. That's an easy fix that a patient
would gain so much benefit if they had the appropriate
levels of vitamin D. So you'll go in with my
medical assistant into her office. She'll get your blood work.
We do it all on site. You're going to get
out a segmental body composition scale. So what it's really
(22:17):
going to do is going to scan you three hundred
and sixty degrees. It's going to tell us your body
fat percentage, your lean mass, your water weight, your visceral fat,
which is the fat this runs your abdominal organs. That
really gives us a really good picture of kind of
what's going on. If we could benefit from some weight loss,
maybe benefit from building some muscle, anything like that. So
once you get done with my medical assistant, she'll put
(22:38):
you an exam room and then I'll come in and
we go over all the things love and at that
visit we decide what we're going to start you on
if you want to start that day. I dispense the
medications out of my office, so there's no downtime. You
leave with them and you get started on them. Easy
pezy line. That'squeazy.
Speaker 2 (22:53):
I am so excited for everyone to check you guys out.
Speaker 1 (22:57):
You guys are awesome.
Speaker 2 (22:58):
I've had such a great experience and so thank you
so much for sharing that information. I think it's gonna
be super helpful, and so if you guys want to
learn more, I'll share their Instagram and their website and
its advanced Medical Wellness
What's up, guys. I'm so excited.
Speaker 2 (00:03):
I've been talking about my hormone journey for what six
months now and how I've been going to Advance Medical Wellness,
and I'm so pumped because Callie is joining us. She's
the owner and practitioner at Advanced Medical Wellness.
Speaker 1 (00:17):
Welcome, thank you. It's a pleasure to have you after
all this time.
Speaker 3 (00:21):
So excited to be here.
Speaker 2 (00:22):
I know. So I've been sharing my journey on social
media for the last I think since September of last year,
and I was like, you know, I want to go
through this journey and really have some like experience under
my belt before I start talking about it, right because
I'm like, I want to make sure that I'm recommending
something that I really believe in, and naturally I do.
Speaker 1 (00:43):
And so I was like, we.
Speaker 2 (00:44):
Got to get Cally in here to tell people we
have lots of questions. So we had a lot of
listeners comment yesterday and want to ask you questions. So
should we just like dive right in? Dive in, Okay,
before we get to the question, So I do want
you to tell me a little bit about Advanced Medical
Wellness and why you started the practice.
Speaker 3 (01:01):
Yeah, absolutely, So I started Advanced Medical Wellness in August,
still be four years ago, and I really started the
practice out of a passion for the industry. I want
people to feel better, whether that's losing weight, whether that's
fixing their hormones, whether it's just being a good practitioner
where people can walk in and know that you know,
(01:22):
no matter what's wrong with them, they feel sick or
they feel tired, we're there for them and we can
help them. So it's really just a passion for the
industry and just wanting people to live healthier and live longer.
Speaker 2 (01:32):
Love that, And you guys are in all women's staff,
which is pretty cool.
Speaker 1 (01:35):
Yeah, yeah, I love that.
Speaker 3 (01:36):
Yeah yeah, as a girl, absolutely.
Speaker 1 (01:39):
One of my favorite parts.
Speaker 2 (01:40):
Yeah, tell us about the main three hormones in a
woman's body and how they affect their function every day.
Speaker 3 (01:47):
Yeah. Absolutely, So the three hormones that we usually focus
on are estrogen, progesterone, and testosterone. We have other hormones
in the body, but those are the three that we
can control, so those are really what we're looking for.
And so when it comes to estrogen, you think bone health,
you think heart health, you think collagen in our skin
(02:09):
and things like that. Testosterone is the one that's really
important for energy, okay, sleep, libido, things like that. And
then we've got progesterone and that's really the calming hormone.
Typically we give that at night. That's because it helps
with mood. It's really calming and it kind of stabilizes
our mood.
Speaker 1 (02:26):
Okay, And that's the trifecta.
Speaker 2 (02:28):
Those are the three that we're trying to that's get
optimal results with.
Speaker 3 (02:32):
Those are the three as a provider that I can control,
that I can help with, and that's why we focus
on those.
Speaker 2 (02:38):
So you offer something called bioidentical hormone replacement. What does
bioidentical mean?
Speaker 3 (02:44):
Yeah, absolutely, it's a great question. So bioidentical is exactly
how it sounds. It's identical to what our bodies are making.
So what they're saying is, even though we're taking it
from the outside in and our body isn't making it itself,
it's identical. They've created in the lab what's identical to
kind of what our body is used to, so we
(03:05):
use it better and it's safer. So when you hear
about hormones, it's either bioidentical or synthetic. And the one
thing that we always focus on is bioidentical because our
bodies accept it better.
Speaker 1 (03:15):
Okay, and synthetic is like, quote unquote not real. It's
like hormones.
Speaker 3 (03:19):
It's close. Here's the thing. It's close the way that
they make it in the lab, but our body doesn't
like it as much as our natural So we almost
have to trick our bodies into thinking that we're actually
making it so we can get the result that we
want when we give it to the patient.
Speaker 2 (03:33):
A lot of times women go into the doctor and
they get their blood work and they're like everything's fine,
and they're like, I don't feel like everything's fine.
Speaker 3 (03:41):
Yeah.
Speaker 2 (03:42):
So for the women out there that are going to
go get blood work, what do they need to ask
for to get a more in depth reading or look
into their hormones instead of being told everything's fine.
Speaker 3 (03:52):
And So, as my career has progressed and I've learned
a lot more and I have a lot more education,
I've learned that when you go into the doctor or practitioner, nurse, practitioners, pas,
it matters who you're sitting in front of. Okay, what
you have to understand is years ago when they decided
(04:12):
what's normal. What they really did is they took let's
say a thousand patients, and they said, and it looks
it's kind of shaped on a bell curve, right, And
they're saying, Okay, the bulk of these ninety five percent
of patients is what we're going to consider normal. But
what you don't consider is those ninety five patients that
are normal could have diabetes. Those ninety five percent of
(04:35):
patients could have hypertension, high blood pressure, they could have
high cholesterol, they could have active cancer and not know
about it. So that's what you really have to ask yourself.
It can't be if you don't If your lab says
that you're normal, but you don't feel normal, you are
not normal.
Speaker 1 (04:50):
Let's talk about testosterone specifically.
Speaker 2 (04:52):
Okay, when women hear the word testosterone, it's kind of intimidating.
Speaker 1 (04:56):
I'm not gonna lie. I was also intimidated at first. Yeah,
So are.
Speaker 2 (05:01):
There things that we as women should worry about when
we take testosterone like a deeper voice, or more body
hair or acne like those kind of things.
Speaker 3 (05:10):
No, all great questions and all great concerns, but again,
sitting across from the right provider, you should be able
to bring these things up, and the provider should be
able to give you the data and the evidence to
say there's really nothing to worry about. So I think
when you know, just to give you a reference point,
a woman's testosterone optimally, if you look at a lab,
they're going to say five to forty's normal. Well, optimal,
(05:31):
we know that we like levels around eighty to one hundred,
and anecdotally in my practice, I know that women feel
better there, and when they feel better, they function better.
So if you think about it, optimal for a man
is usually over like eight hundred and so what Yeah,
we are not trying to get a woman over eight hundred.
That is no way we tried to you.
Speaker 2 (05:50):
Okay, So when you're balancing optimally for a woman, your
levels are around one hundred, where a man's is eight hundred.
Speaker 1 (05:57):
So we're nowhere near where a man's TESTASAE.
Speaker 3 (06:00):
I mean, I have men that run eleven twelve hundred,
so my goal is always a man over eight hundred.
But that's not one hundred percent of time. If I
have a guy that's six fifty, but he feels amazing,
rock on.
Speaker 1 (06:12):
So is it true?
Speaker 2 (06:13):
Though? Then hormones aren't necessarily a specific range.
Speaker 1 (06:17):
It is more based on how you feel.
Speaker 3 (06:19):
Absolutely.
Speaker 2 (06:20):
So if I feel good at like sixty, that's great,
but someone else could feel terrible at eighty and then
need to bump it up.
Speaker 3 (06:27):
Absolutely. And the other question is a lot of times
it's not just medication. Right, you feel good at sixty,
the next person comes at a one hundred and they're like, gosh,
I'm still tired. As a provider, I'm looking and I'm saying,
how's your sleep, are you drinking enough water? Are you exercising?
What's your stress level? Like, all those external things affect
(06:47):
the way that our bodies function, and they accept medication.
So those are things that need to be addressed.
Speaker 2 (06:51):
Yeah, we can't just like take hormones and then expect
it all to be fixed. I still like lay in
bed at two am and eat a cheeseburger. I think
it's going to be fine. As a woman, When you
hear about hormone therapy our entire lives, it's like, that's menopause.
That's when you're in your forties and fifties and sixties.
But a lot has shifted recently and now women in
(07:13):
their thirties are starting to address it. What can women
in their thirties start looking for and being like.
Speaker 1 (07:19):
Okay, this isn't normal.
Speaker 2 (07:20):
This is something that needs to be addressed before it
gets too far off.
Speaker 3 (07:23):
Oh my gosh. Absolutely, so I think that what's important
when you think about hormones, the big one is energy,
brain fog, hair thinning, changes in your skin. Maybe you
start carrying weight around the mid section. Maybe you all
of a sudden have some sudden weight gain and you
didn't change anything. So those are really or mood swings.
(07:43):
Your mood could be really low, your mood could be
really high. I have patients every day come in think
that they're struggling with mental illness and Priscilla, it's a
hormone imbalance, and we fix their hormones and they're like,
oh my gosh, Kelly, I'm not anxious anymore. And I'm like,
it was just your hormones.
Speaker 2 (07:57):
It's really crazy because we are taught to be accepting
of like that's just how it is.
Speaker 1 (08:02):
When you age, you age and all of that changes.
Speaker 2 (08:05):
But I don't think people realize and if they did
that just by hormone balancing and getting your hormones in check,
you can revert back to what feels normal for you.
Speaker 3 (08:15):
Oh my gosh. Absolutely, And you know.
Speaker 1 (08:17):
The belly fat doesn't have to be there. Doesn't just
because you're older.
Speaker 3 (08:23):
No, and it doesn't. And you know what, I think
that patients get stuck in the mindset of what's happening
right here, right now means forever. Yeah, But the beauty
of life and the beauty of all of it is
that it can be changed with the right team in
front of you. Yes, anything is possible. And I know
sometimes to think about it, when your mood's low and
(08:44):
you don't feel good and you're unhappy with your weight,
you're thinking, this is me forever, this is just how
it's going to be, and it's not true. Get the
right provider and get the right team in front of you,
whether that's me or whether that's my colleagues that are
great at this. Anything's possible. It really is. As long
as you're willing to show up and walk through my doors,
it's totally possible.
Speaker 2 (09:02):
How do you know when it's time to start hormone
replacement therapy and at what age should women start paying
attention to that?
Speaker 3 (09:08):
Yeah? So what you really the best predictor for us
as providers is your mom. So if mom went into
early menopause, that's usually a good predictor for us. Not always, yeah,
not always, but sometimes when you're ovaries, which are what
produced all of these hormones that we're talking about, when
they fail early, meaning they just don't work like they should,
(09:31):
not that they fail, just that they're not producing what
they should, we call it premature ovarian failure. And typically
it's genetic. Typically we can see that in your heritage
home or whether mom didn't or grandma did. Usually we
can track that. Sometimes not everybody's body is different. We
have some women that go through chemotherapy that will cause
(09:52):
them to go into menopause early. So I don't you know, honestly,
Priscilla is a twenty one year old going to walk
into my office. Probably not. But in your thirties, if
things are changing and you don't feel normal, there's usually
a reason, you know, whether you think it's hormones and
we get your blood work and it's not, you still
(10:15):
need to talk to somebody. So I don't think there's
a right or wrong answer. But what I will say
is there's a lot of data since twenty twenty two
that's come out that's proved to us that actually replacing
estrogen in the mid to late thirties protects our bone,
it protects our the neurons in our brain, it protects
(10:35):
our heart. So there's a lot of benefit to It's.
Speaker 2 (10:38):
That's great to hear because again, like I remember, I
went to a provider in obgyn and I was like,
my cycle changed, and it wasn't like a gradual getting
older change. It was like within three months, it was
just different. And her response was, well, you're getting older, right,
And I'm like, I get that, but also it shouldn't
be that like I have been. I've had the same
(11:00):
for like ten, twelve, fifteen years, and so you're telling me.
So not getting dismissed is also a big deal, and.
Speaker 1 (11:09):
Being heard is so important.
Speaker 2 (11:11):
And I think that's what's really great about your guys
this practice is because I think I've like ran over
my appointments so many times because I've just shared so much. Yeah,
you just listen, absolutely, and that's the best part because
you consume everything that your patients say, and then you
uniquely because my husband also is a patient and our
visits are vastly different, and not just because we're men
(11:32):
and women, but because his needs are so different than mine.
And that's what's super cool is because like you accommodate
everyone individual. It's not like a one size fits all.
Speaker 3 (11:40):
No, you have to meet patients where they're at. I mean,
that's what's important. It's you know, I precept nurse practitioner
students and I always tell them, I say, you know,
I'm not the smartest nurse practitioner out there, and I
didn't graduate the top of my class. Close, not the top,
but close. But I always tell them, I say, the
(12:00):
reason I accept nurse practitioner students and I extend myself
to them is to show them that there's a different
side of medicine. And so that's the most important part
is I don't know everything, and I'm not the smartest
person in the room, but I won't give up and
we'll figure it out.
Speaker 2 (12:16):
That's I mean, I think that's all any patient can
ask for. Absolutely, who would you say hormone therapy is
safe for?
Speaker 1 (12:23):
And who do you not recommend getting it done?
Speaker 3 (12:26):
Yep? Absolutely So when you do a consult history of
cancer is very important. So it's funny because you hear
everybody's talking about hormones now prior to twenty twenty two
is taboo. That's because a study came out in twenty
twenty two. Previously, we thought if you go on bioidentical
(12:47):
estrogen and testosterone, that it was going to increase your
risk for breast cancer. And so when we hear that
as providers, our number one oath is to do no harm.
We're not even going there for sure. So in twenty
twenty two, a great study came out and basically told
us that everything we thought you wasn't true. Breast cancer
is very important to us, Ovarian cancer is very important
to us, Uterine cancer is very important to us. Those
(13:08):
patients we absolutely wouldn't we wouldn't risk now. Is that
a blanket statement of one hundred percent of patients with
a history of breast cancer any type of cancer as
a no no. But they usually have an oncologist, and
that's my job to collaborate with the oncologists to say, hey,
this is what we got. Is there any options here now?
Speaker 2 (13:26):
Is it for all of the hormones or just estrogen specifically,
So it's it's all of the hormones, because what you
have to understand is there's a balance.
Speaker 3 (13:35):
So we are, you know, our ovaries make our ovaries
and adrenal glands make the three hormones. But it's all
about the balance. So we can give one, we can
give two, we can give three, but what we really
want is that perfect synergy between all of them. So
it's not just it's not just estrogen. What we think
a lot of breast cancer now we hear feeds off estrogen, right,
(13:56):
But what you have to understand is when your testosterone
levels starts to increase, your body sometimes wants to turn
that into estrogen, and so we would be very careful
with that. If the patient has a history of any
type of breast cancer.
Speaker 2 (14:07):
And is it cancer with them specifically or their family lineage.
Speaker 3 (14:13):
It's really just the person. If there's a history a
breast cancer, there is a breast cancer gene called the BRCA.
We call it the BRAKA. You know, we would be
very very cautious if a patient that's a positive. Absolutely,
and but it's it's a it's a team effort. I
can't tell you how many conversations I've had with oncologists, Hey,
(14:34):
what do you think moving forward? And cardiologists too. You know,
if there's any subspecialty in the mix, you know, oncology,
heart usually neurology not so much. But it's important that
the practitioners willing to collaborate with that subspecialty to make
sure that it's safe for the patient.
Speaker 2 (14:49):
Can hormone therapy and glp ones help women with pcos absolutely?
Speaker 1 (14:55):
Okay, tell us all about is, what, when, where? And why?
Speaker 3 (14:58):
Isn't it beautiful? Oh my gosh? Okay, So my core.
I have a specialized certification in OBCD medicine. So that's
OBCD is defined as people think struggling with their weight,
but it's really just a woman's body fat percentage over
thirty four percent or a body mass index over thirty
or a body mass index over twenty seven with a
(15:18):
comorbid condition, meaning you have high blood pressure, high cholesterol
with that. So GLP one medications are great for weight loss, right,
they were originally designed for diabetes, now we use them
for weight loss. When women have polycystic ovarian syndrome, a
lot of times they have cysts and things like that,
and that can cause metabolic dysregulation. It can cause them
(15:40):
to their insulin levels are high, which makes them store
body fat, which is why a lot of times they'll
carry fat around the mid section. So GLP wants help
with that. The insulin levels go down, they lose weight,
and the PCOS tends to resolve itself. Wow, So not completely.
I have seen it.
Speaker 2 (15:58):
You know.
Speaker 3 (15:58):
I've had lots of patient who had had a diagnosis
of PCOS, you know, in their younger years, and they
get on GLP ones. They do great, we clean up
their diet, they lose a bunch of weight and they don't.
Speaker 1 (16:11):
Have undetectable don't have it.
Speaker 2 (16:12):
That's amazing how much distress and cortisol actually impact our
hormones and what can we realistically.
Speaker 3 (16:20):
Do about it?
Speaker 1 (16:23):
Like it's the biggest one.
Speaker 3 (16:24):
Okay, so it's totally the biggest one. Because I feel
like hot topics come out, right, hot topics come out,
women's testosterone. We're gonna talk about it. You know, Cortisol.
Cortisol does. Cortisol's a stress hormone. It makes us hold
on to body fat. It can slow metabolism. Absolutely. Here's
(16:45):
the tricky thing with cortisol. There's nothing we can do
about it. So sometimes I'll have patients come in and
they're like, oh, my cortisol's probably through the roof. Can
we check it? Yes, realistically, we can check it, but
as a provider, I feel like I need to be
honest with you. And even if we have this high result,
there's nothing we can.
Speaker 1 (17:03):
Do about it because is it lifestyle related?
Speaker 3 (17:05):
It is it stress, So you have to.
Speaker 2 (17:07):
Manage your lifestyle. There's nothing Kelly can do for you,
at least in that department.
Speaker 3 (17:12):
Yeah, and here's the thing, you know, I feel like
it's lifestyle stress, but I think more plays into that too.
What's your diet look like? Yeah? Are you struggling with
anxiety depression? Can we get you into a therapist, you know,
to make you feel a little better. Are you exercising?
Speaker 2 (17:28):
Like?
Speaker 3 (17:28):
There's other things that we can do to lower that,
do you know what I mean. It's just it's hard
for me as a provider because gosh, I wish I
had something to give people except like, oh, hey, go
get a new job, Like that's going to happen, right, Yeah,
But I feel like, yes, it does, but unfortunately there's
not a lot that we can do about it.
Speaker 1 (17:46):
Yeah, but that's good to know that.
Speaker 2 (17:49):
See. I like that honesty though, because then it gives
people the reality and it makes them look within and
it's like, Okay, this is something I need to internally fix.
I can't outsource, say, you know what I mean. There
are a bunch of different ways to take hormone therapy. Yes,
what are those ways and what does your clinic offer?
Speaker 3 (18:08):
Yes, so there are many different ways to take it.
Estrogen can be taken by a tablet. Estrogen can be
taken by cream, Estrogen can be taken by patch. Progesterone
can be taken by injection. Progesterone can be taken by
a capsule, and then testosterone. There's creams, there are trophies
(18:30):
which are just kind of like tabs that dissolve in
your cheek, under your tongue, and then there's injection. So
I will tell you as a provider, I don't have
a lot of absolutes in my life, right. I like
the gray area. I think that everybody's different and we
kind of have to bend and move to find what works. Yeah,
the one hard and fast I have in my practice
(18:51):
is I only give bioidentical hormones a certain way. So
I only give estrogen by patch because when you take
it orally you can have an increased risk for blood clots.
Sometimes women don't do very well with it. Orally. It
can be hard, a little bit harder on your liver.
And if I give a woman a cream, what if
you put on a shirt and you sweat in Arizona
(19:12):
and I don't know your rate of skin absorption versus
the person next to me. But if I give it
to you via patch, I know that you're going to
absorb that. We can do twice weekly patch, once weekly patch.
I can control the estrogen that's going in your body.
Testosterone I only give by injection. It's going right into
your bloodstream. Yeah, we can control it. Like that's my
(19:32):
big thing is new. There's pellets. Two pellets are the
big thing. They do the surgical procedure. They put these
pellets in and it's like, oh, hey, have a great time,
see you in three months. Hope you don't have a
side effect because there's nothing I can do about it.
If I give somebody testosterone and say they're an over
responderikey for the record, I can fix it in real
time in one week, Like I can fix it.
Speaker 1 (19:54):
I was I am that person.
Speaker 2 (19:56):
I So I'm doing testosterone injections and my body is
super sensitive, so we have had to adjust my dose
like five times. I think and it's all I mean,
it's me, it's my body and the way it's responding
because I've never done it before, right, So we're learning
as we go, and I am so grateful for the
weekly option versus like, can you imagine if you would
have started me and I had a pellet and I
(20:18):
would have had three months of like skyrocketed testosterone.
Speaker 3 (20:21):
Absolutely, you felt terrible.
Speaker 1 (20:22):
It would have been awful.
Speaker 3 (20:24):
So that's the one I'm so I'm such a I
call myself a control frequ when it comes to the
way that I give hormones. But they're the most data
driven I can. I can predict the outcomes so much
better than I can these ones where you take it
orally you know, you maybe absorbed thirty forty percent of it.
So that's how I give testosterone. It's just subcutaneous injection, right,
(20:46):
that doesn't have to go on the muscle, It's just
a little insulin needle. And then progesterone is micronized capsule
at night, and that's the safest way to give progesterone.
Speaker 1 (20:54):
Yeah, I love that.
Speaker 2 (20:56):
Okay, And for the record, I do progesterone and testosterone
and I've not had any issues, so far Ye, we're good.
Speaker 1 (21:03):
Last question.
Speaker 2 (21:04):
Now someone's gonna come to advance medical wellness and they
want to start from the beginning. They've never done this,
no experience. What does that look like from beginning to
start of treatment?
Speaker 3 (21:14):
Yeah? Absolutely so they would you would call, you would
book online. You would talk to our patient coordinator, which
typically is my registered nurse who's amazing, by the way,
So she'll give you a whole breakdown of the program,
kind of the ins and outs, and talk to you
is a patient too, what are you feeling? Because she
can get a good gauge as to kind of what's
going on with a patient before they get to me.
(21:34):
So you'll get booked with me. We'll get blood work
at your first visit. We typically like it to be fasting.
We're gonna check, We're gonna I'm gonna go in depth, right,
I'm gonna check your blood sugar levels. I'm gonna check
your cholesterol. I'm gonna check your vitamin D levels because
those numbers matter too. I can't tell you how many
times I've had a patient sitting in front of me
thinking it was hormones and part it was, but they
(21:56):
were a diabetic and they never knew it. Oh wow,
absolutely so, So it's one of those things or really
low vitamin D. That's an easy fix that a patient
would gain so much benefit if they had the appropriate
levels of vitamin D. So you'll go in with my
medical assistant into her office. She'll get your blood work.
We do it all on site. You're going to get
out a segmental body composition scale. So what it's really
(22:17):
going to do is going to scan you three hundred
and sixty degrees. It's going to tell us your body
fat percentage, your lean mass, your water weight, your visceral fat,
which is the fat this runs your abdominal organs. That
really gives us a really good picture of kind of
what's going on. If we could benefit from some weight loss,
maybe benefit from building some muscle, anything like that. So
once you get done with my medical assistant, she'll put
(22:38):
you an exam room and then I'll come in and
we go over all the things love and at that
visit we decide what we're going to start you on
if you want to start that day. I dispense the
medications out of my office, so there's no downtime. You
leave with them and you get started on them. Easy
pezy line. That'squeazy.
Speaker 2 (22:53):
I am so excited for everyone to check you guys out.
Speaker 1 (22:57):
You guys are awesome.
Speaker 2 (22:58):
I've had such a great experience and so thank you
so much for sharing that information. I think it's gonna
be super helpful, and so if you guys want to
learn more, I'll share their Instagram and their website and
its advanced Medical Wellness
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